I am a night care assistant in an elderly residential home. AMAA!

My short bio: Hi, I work as a night care assistant in the UK for a residential home specialising in care for the elderly. I've been doing it for a few years and love it. I've never worked a day job in my life, opting to work night shifts when I was offered a contract and I just fell into it naturally. I'll answer pretty much anything I feel I'm allowed to. Be intricate and loving, but always wear your gloves!

It's very emotionally draining, especially on nights when it's paramount you get enough sleep to get you through another shift. Your patience can wear thin when residents take a while to do things or appear to be off with you. I try to remember it isn't their fault, I'm there to do my job and I'm there to be their shoulder. Whatever they need, I get, and whatever they need doing, I do. It can be quite relentless. My residents don't sleep all night either - they're quite active, often showing a completely different side when the sun sets.

Honestly? I'm not. A lot of my hobbies are very inwardly focused - I read a lot, I write, I draw, I produce music and I occasionally see my close circle of friends. I wouldn't consider myself a happy person but I look after myself.

Surely if you're on night shifts, then you are meant to be awake all night on the lookout for patients who start wandering or get confused? Does your home make you do night shifts followed by day shifts? If so this is appalling.

No, we have set shifts - one team for nights, another for days. Different job roles but we all aim to do the same thing which is provide a safe environment for residents to live in, eat well, socialise, keep busy and stay active. I don't just look for wanderers; that's just a small part of my job. I don't think it's legal to work a day shift after a night shift and vice versa.

Ohhh, now I see why that can be misconstrued. Yes, I should have been more clear - I meant sleeping during the day in between shifts, because it's harder to do and regardless of how much I get I still have to feel refreshed enough to attend work.

Do you mean following routines? If so, we promote independence whenever possible. We have set meal times of course and even days where we give baths to residents, but it is completely their choice and we will adapt our schedule around their preferences as best we can. I always like to think I work in their home; they don't live in my workplace.

I know that's right. I would start very early in the AM. Usually around 5, sometimes a touch earlier. So it would still be "night" to a lot of these folks. One home, there was a group always in the sitting room. One of the ladies would sit there the whole time I was there and do this:

"Lady! Laaaady! Do you know what's going on here? I can't move my arms. Help me! Oh. I guess it's OK. I just had to move the blanket. Help! Help! My nose is bleeding!! Oh, it's OK. It was just dripping. Heeeeelp! Help! Help me!"

And she would do that all the time. I asked the nurse once "does she do this all night?" and the nurse said "Yep. And most of the day, too". I was like "IDK whether to feel sorry for her, get mad, or laugh". And the nurse said "Yeah neither do we".

I've done similar work (traveling lab tech who goes into care facilities).

A couple questions for you:

What do you do when someone is actively dying and there's no one who's come to see them? I sat on the end of a lot of beds, talking to someone who maybe couldn't hear me (tho they say hearing is the last sense to leave).

What's the grossest thing you've ever had to see or handle?

What's your One Thing? Everyone in healthcare has one. Blood, vomit, stool, eyeballs, feet, all that I'm OK with. What brings me to my knees gagging? SPUTUM. I just can't with sputum. I'm always like "Is that going to end up on me? Because I don't want that on me. Like, at all. It's going to end up in my hair and I'll have to light my hair on fire because it will never ever come out. Also is this person going to stop breathing like right now?"

I talk constantly. I go to their rooms as often as my schedule permits and I talk to them. I don't care if they don't know who I am. To hear something said to you in a nice tone and you feel there's genuine interest, I can't imagine there's much better when you're in that position.

A vile case of diarrhoea that was like black tar gushing out of someone. They had a nasty virus brought back from the hospital and it was just a nightmare. It was everywhere. We had to bin almost all of the bedding. Washing it would have been impossible. I'm not usually bothered by fecal matter but that smell has stuck with me.

I can't handle phlegm at all. Sick, blood and other nasty substances don't phase me at all (usually, see above) but I just can't deal with phlegm. Just saying the word makes me feel queasy!

Sputum and phlegm are unpleasant enough words, but if you want clarification, it's the thick substance that is commonly coughed up. Looks like clear jelly. Disgusting stuff. Imagine the cough from a smoker multiplied by 100.

I've never been bothered by piss and shit. It's just a fluid to me. It's something we all do. My residents do it too. I just get on with it. It's all come from the human body and that's all we are when you boil it all down so how can I judge or express disgust when it's in all of us? I just clean it up and move on!

I was on a unit that had an outbreak once. 18 of the 24 patients on the unit had it, it was terrible. We had to put them all on isolation and we frequently ran out of isolation gowns and had to steal them from surrounding units. It was a nightmare.

Hi there. I'm a Dutchie from the Dutchlands, and my father was in a care facility for several years after suffering a stroke. My brother and I visited him regularly, and I like to think those visits were the highlights of his days there.

Unfortunately he was unable to speak as an effect of brain damage due to the stroke, but I am sure that if he would have been able to speak he would have described his being there as a fate worse than hell. You could see it in his eyes. Death came to him as a release.

I must say, the staff was very caring and loving, but there were the usual religious nuts among them (my father hated all things religious with a passion). Also, the staff was very overworked and welcomed any help they could get from me and my brother.

I'm not sure there is a question in the above, just wanted to vent a little bit.

Not a problem. It's nice to hear the positive. Unfortunately, I hear more negative things than positive and that can be taxing. I'm happy you're satisfied and don't think we're monsters, haha. I myself am not religious but I do know of some. It's just as tiring for me - trust me.

How often does beating/abuse of patients occur in elderly residential homes? The reason I am asking is because both of my grandparents have been in homes and I was always curious about this sort of thing.

In my experience? Very rare. The cases you hear on the news are disgusting. Everything is recorded and suspicious activity is monitored very closely. The people I have worked with have been gentle and kind people who really do want to help. That's why they're in the job they're in. They wouldn't last if they didn't want to do.

We made the difficult decision to place our grandmother in a dementia care home when it was no longer safe for her to live in her home with home care nurses. The staff were angels and so dedicated and caring. I still remember them fondly. Just want to say thank you because you sound the same. :)

White - all carpet colours are subject to change, and we welcome all schemes, food or otherwise. If it's a hazard or unhygienic we'll clean it however, so no jazzy patterns.

Sexual comments? Ohhh, I get a few risque ones. My favourites are the women that say they could teach me a thing or two, and all I can do is chuckle. My all-time favourite quote though was from a man - I asked him if he was a lover or a fighter and after a few seconds of pondering he replied "it depends where you put your chin". I loved it.

War stories are something I don't hear all that much of. In my old job, I did have a man who had a false leg made in the same country as he lost his real leg in. He saw the funny side.

A friend of mine used to deliver the meals to each of the rooms at a rest home. He told me quite a few stories of how some of the residents would beg or try to sneak out with him. How often do you see this actually happening?

Not too often - we have those that do try to leave (usually at night) but that's because they feel confused and forget where they are. Once I point out how dangerous it is (and because it's England, wet and rainy) they often change their minds and go back to bed.

Also, I've seen an example on reddit of certain nursing homes setting up bus stations to look like actually city stations where the residents could get on and go ... wherever they thought ... they were going when the buses would simply make a trip around the block and then bring them back to the home. Do you think something like this would help or hurt?

I've seen that before. It's a novel idea and it does work. It's hard to say if it's helpful or harmful though. It's a good thing to maintain the illusion of normal life but there is a line. I used to think it was quite crafty but things like that are set up for the resident's safety. If such a thing wasn't there, who knows where they'd end up?

That's a really common saying, and you can attribute it to anything - I've also heard the variation "bad news comes in 3's". Truth be told, yes, we do get a few deaths all at once and all of a sudden but I wouldn't call it a "rule". It's more of a coincidence. There's no such force ruling that people die in a set number; rather, a common illness can grip people and take them in quick succession to the point it feels like a pattern when really it's just bad luck.

How old is the average worker in your field? Is there a physical element which means that you couldn't do the necessary assisting to others into retirement age? I'm not trying to offend, I just work in care myself (special ed/different needs) and couldn't imagine helping mobility for my clients for the next few decades.

Average age? That's a new one. It's mostly women, but their ages vary. Many of them are over the age of 30, but we're all there for the same reason so it's hard to say. I don't mind assisting my residents and they don't see it as weird because I've been doing it for so long.

Thank you. I am glad there are people like you doing this work. In my close family, we have avoided institutionalization by working very, very hard so our loved ones can be cared for at home. But I have more distant family and acquaintances that have moved to such places, and I worry about them. I know that the terrible stories in the media are the exceptions and the worst cases, but it is still very worrisome when you know that your dear one can't communicate for themselves or let anyone know if something is wrong. It is very reassuring to know there are people like you caring for them. I can't even imagine how backbreaking and soul-breaking the work is. Thank you.

I worked as a patient care tech for 1 year during nursing school, and it was the most physically demanding, emotionally draining job I've ever had. Aides are so understaffed, underpaid, and under appreciated. Thank you so much for what you do, us nurses really couldn't do without you!

Unfortunately for many who ask this, I don't really believe in anything paranormal. I've had my moments where I've seen or heard something and thought "holy shit" as the hair on my arms prickled, but nothing I haven't been able to explain. I might see shadows or even figures out of the corner of my eye but they just turn out to be wandering residents.

My colleagues on the other hand are a tad more believing, and have claimed to hear or see strange things. I'm yet to see anything for myself, though.

I'm assuming immediate family is who typically ensures that residents get regular and needed medical and dental care visits. If you find no one takes them and they are unable to independently arrange for care - is there a way to intervene or an existing program to ensure they get proper medical and dental attention (at least on a regular basis, not just for emergency or immediate needs)?

Interesting question, and embarrassingly it's one I don't have a clear answer to. In most cases, there is at least a next of kin who will arrange things such as GP visits and dental maintenance. I do know we have associations with the chemist and every resident has a GP assigned to them when they come to us, so they can at least be seen and prescribed things as we feel they need it. For example, if somebody is consistently unwell, we may phone for their own GP or a call-out service who will come, assess them and perhaps prescribe a course of antibiotics. Health is paramount - as well as ensuring their holistic needs are met, we also strive to keep them as healthy as we can. If I'm not clear enough I apologise.

The reason I ask is that, once in a while I have an elderly patient who gets care once in a while... But whenever I see them, they have plenty of needs. Things are deteriorating fast and they are unable to truly care for themselves (independently). Sometimes, they can't come, but they need to - a year passes and things are even worse than before.

There has been an occasion where I've picked them up myself.

Another way it goes is, the person doesn't want their children to "interfere". Sometimes, they would prefer the aid of a stranger than their own children for fear of being a burden or feeling less independent.

It's never easy. Sometimes it's worse being pushed away by the very person you wouldn't have dreamed would do such a thing. If you have concerns for any patients, I'm sure you could ring a service similar to the Samaritans or Social Services to express your concerns. Homes are varied and provide different care depending on people's needs.

It's very sad when you think about it, but we can only do our best. If I've done all I can and made even a tiny bit of difference, that helps me keep going and try and provide even more assistance.

Thank you. It's draining, difficult, often thankless work, but I enjoy it and it's worth it just to interact with my residents in a unique way. They trust me with pretty much anything and it feels good to be there for somebody.

Good question. Some do genuinely enjoy living there. Some have been forced to sell their home and move in with us because of failing health, and that again is split into two groups - those that have grown used to it, and those that really miss their own home. I can understand that angle as I'd hate to feel uprooted, but in most cases these people could not survive alone or with the resources they had at the time. We try to make things as comfortable as possible. You of course get those that dislike it immensely, but not as often as you may think. I don't meet many residents that hate it immensely - honestly, a lot are happy to have that support and safety.

It sounds soppy, but the smiles and gratitude I get from my residents. I have a good relationship with them, and my colleagues are for the most part really nice and (obviously) caring people. I don't dread going to work very often.

Lol gotcha. My wife works overnight per diem on the skilled unit at a similar place and she refuses to talk to me when she's there because she's too busy.
Figured if you can do an AMA she can send me a text or two :)

I feel saddened because I love my own parents and grandparents to death and couldn't bear to neglect them. I have to accept people are sadly built different and don't hold the same values I do. I can't change how they think, and getting annoyed with them solves nothing. Instead, I try to be as close to a relative as I can.

Also, thanks for doing what you do. I couldn't. My great aunt was in a small, run-down nursing home when she had advanced Alzheimer's, and the staff was amazing! Everyone was really warm and they all knew all the residents by name. She didn't have much more than a brain stem attached to a body by then, so I don't think she noticed that her caretaker picked flowers for her room and whatnot. Still, it was a comfort to us to know that she was being well-cared for.

There are different kinds of favourites to me if that makes sense - there's the well behaved ones who don't give me any trouble, and there are the ones that misbehave and constantly make dry remarks. I love both.

When someone passes away, how are they taken out of the facility discreetly?

I ask because I have a family member in one of these places and to get someone from their room to out of the building, they'd have to go through the day room/cafeteria. I just can't imagine they'd wheel someone who's deceased on a stretcher through a public area like that.

That sounds like poor planning, because usually there's a route out of these kinds of buildings that don't necessitate passing anybody. If in the unlikely event somebody passes in the day, we close the doors to communal areas and have a member of staff floating about to distract residents or generally make sure the more wandersome don't cross paths with the unpleasant sight of a stretcher being wheeled out of the building. Obviously it's a little easier at night, but I imagine it's tricky in the day.

My training hasn't specifically dealt with LGBT social identities, but only because it isn't so common in elderly residents in my experience. Despite this, we're trained to respect everyone and be tolerant as our beliefs are bound to be different and it is far from personal. As for sexual encounters, I'm going to be honest and say I haven't seen much in the manner of that kind of behaviour. If I haven't answered your question, do feel free to message me and I'll be happy to elaborate.

As someone entering the EMS field for the first time, I have heard more complaints and horror stories about nursing homes than any other aspect of the job. Nursing homes have a terrible reputation for institutionalized neglect and substandard medical care. The relationship nursing home staff have with EMS and hospital staff is typically hostile at best.

Can you tell me about your experience with EMS? Do you have generally good or bad experiences with paramedics? What should a paramedic know about you and your job that would help to understand your position better?

I generally have a good relationship with paramedics. I think a lot of the hostility comes from conflict of interest - I feel they think I'm wasting their time when I call emergency services for what seems like a banal and pointless reason. In truth, I have to telephone the emergency services at the slightest drop of a hat. If I ignore it, I could face scrutiny in my own workplace and risk my job. It's better to be safe than sorry and while I may look like a bit of a dick to paramedics who put me right, it really isn't my place to make decisions like that. I have to phone them in certain situations. I wish I didn't have to but that's how the mop flops unfortunately. I understand that it's a trivial matter but the fact is I'm only doing my job and it's company procedure to phone 999.

Ideally, I'd like paramedics to know I am not deliberately wasting their time. I know they have more important things to deal with at the time, but if I didn't phone them, I would be put under a lot of pressure by my boss and risk losing my job. We're all in the same boat. I don't need cynicism from paramedics.

However, as I said, that is a rare case and I do generally get on with paramedics. They're largely sympathetic. I just wish everyone thought the same.

I don't use a computer at work. Every resident has a file which I have to record in. I state if they've slept well, if they had any supper and medication and how they've been through-out the night in general. There's also fluid and turning charts but that's all paper based.

I know some of the signs but how can we detect a Transient Ischemic Attack in others? How is it different than a stroke? What should we do if we think someone is having one?

I've had some very limited first hand experience seeing a loved one go through a TIA, but didn't know what it was when it happened the first time. I'm a little rusty, and I'm sure lots of people have never witnessed one. It might be good to fill people in!

TIA symptoms are very similar to a stroke - limbs are heavy, droop to one side of the face, slurred speech, poor balance and coordination, dizziness. There is about a one in 10 chance those who have a TIA will experience a full stroke during the four weeks following the TIA. If you have had a TIA, you should contact your GP, local hospital or out-of-hours service as soon as possible.

I worked night shifts in several special needs adult group homes which are somewhat similar to nursing homes so I sorta know where you're coming from. It's a hard job and often unappreciated you sound empathetic and wonderful so thank you for doing a hard job. My question would be what would you change, if you could change anything to make it better for you or the residents.

Well, my routine involves both putting residents to bed and getting some up in the morning. I'd like to focus on just one of them so I could dedicate more time towards it. I'd prefer to put them to bed and then after shift change-over, the day staff are the ones to get them up. In an ideal world, that would make my job a little less stressful and more comfortable for my residents I imagine.

I totally understand, I really enjoyed the bed time part too. Usually they were tired and I had one patient who wouldn't go to bed until I came and read him story. It was nice. Mornings were more unpleasant because I was a human alarm clock to them, and no one is happy to hear the alarm go off.

Indeed, I hate getting them up in the morning. I'm lucky to work at a home where if a resident doesn't want to get up, they won't do and I am not to force them. It sounds like that should be a standard everywhere but I've worked in some places where there is very much a numbers game being played. It's very unfair.

Ah with our residents their lives were a little different they attended day programs where they either spent the day in a school like atmosphere or would have a job to do ie: greeters at Walmart or a sheltered workshop where they assemble products etc. They had to catch the van to work. The goal of the homes I worked in was really to work toward them being more independent so they might eventually move out into a less supervised home. Most never did but there were a few that made such progress that they were able to live with a roommate that was also special needs and maybe only have staff for a few hours a day. But even to the ones that never made it to that point having a job did seem to give them a purpose and pride. The people you work with likely have retired after a lifetime of work so it's a little different my residents were usually in their 20's to 50's.

Ah yes, my residents are all over 70, with the exception of one man who is in his 50s and maintains a busy social life out of the home by either volunteering at a garden centre, seeing his mum or line dancing.

What's the ratio of lucid to senile individuals in the home you work at (or does it depend on the time of day, etc... Do most people seem to know who/where they are?). Have you been able to make close friends with any of the residents (or is this not possible your shift consists of them mainly sleeping?)

How has this job affected your perspective on the phrase "living until a ripe old age." Would you yourself be hesitant to dwell in a nursing home/experience your twilight years (if they weren't in impeccable health?)

Sometimes I have free time during the week, and I love using myself to help others when I'm available. Do nursing homes allow volunteers to come and keep residents company (hold a quick chat, bring them small gifts, etc..)

Last one! My mother works as an unemployment claims advocate (for the company represented), and one of her clients is a nation-wide nursing care facility. You would be amazed about what some care workers would do (before getting fired). One lady actually took selfies of herself (while on call) with nursing home residents being unattended to in the background (one man had fallen out of his chair in the middle of the hallway behind her, omg). Anyway, do you experience a lot of inadequate coworkers or people there for the wrong reasons (i.e: just the paycheck). If so, how are they dealt with? Do you and other coworkers openly shun them or are eventually fired for something?

It's about an even split between them. I have grown close to many and vice versa, because some have a late bed time, or some buzz for me in the night to help with toileting or just because they're cold/bored, which is fair enough. I know some better than others obviously, but I do see quite a lot of all of them.

It's an eye opener, and I realise just how lucky elderly people are who don't have to live in a home. That isn't to say it's necessarily a bad experience, but given the choice I'd much rather support myself. Knowing what goes on, yeah, I'd be happy to spend some time in a home, but I don't think I'd want a permanent stay.

Hmmm... I had to to think if I had encountered anything like that, but honestly (and boringly enough) I haven't. We all use our phones in quiet periods but only briefly and it doesn't ever encroach into our jobs. I would never use it in front of a resident, or in such a manner that it violates privacy or concentration. I've had smaller issues like laziness and whatnot, but all I have to do is report them to a senior member of staff and they're dealt with appropriately. There is one woman on days who was an all-round bad carer and after so many chances she was dismissed, but I don't know the full story there.

It varies from home to home, but I imagine many would like the fact you're willing to go and visit some of the lonelier residents. Some don't like visitors but some welcome them so I'd give them a call and see what they can arrange.

Thank you for replying so promptly! You seem like a great human :) Congrats on what you do, and on maintaining such a caring and patient demeanor. Good luck on all you continue on to accomplish! You contain a lot of depth and insight, for sure.

My aunt is a care taker at a home somewhere in the states. And she says that a handful of the workers are very disrespectful. One time when she first started, she told me of this old woman that never wanted to be left alone but she didn't say why. 2 and a half months later she had a night shift and so she decided to go see the old woman. As she entered she noticed a male care taker zipping up his pants and just walked out. The old woman was shaking in her bed. Are there stories like this where you work?

Sounds horrifying. Nothing like that goes on at my home. On nights, we all have a dark sense if humour but we invite the residents in to share it with us - they're never victims of anything of that sort. We love them like family.

My grandpa keeps saying he has needles/splinters in his foot. But when I look its just dry but he does have patches of red skin under his foot. One patch even has broken skin in it. What is that? I'm desperate to fix this problem of his and don't know who to turn to. Please help.

Might be a circulation problem, but I'm only going off where he's feeling it (extremities) and what the skin looks like (red and dry). Does he feel it anywhere else? What medication is he on (if any)? Of course, I'm no doctor, I can only tell you what I know. I'd suggest going to a podiatrist.

I can't say I have any questions, but just want to say thank you for doing such a difficult job.

My grandfather had alzheimer's and when we could no longer care for him at home, he went into the dementia ward at a local residential home. One of us (my grandma, his kids or us grandkids) would be there pretty much all day and evening in shifts but since we all worked, there was no one overnight. He kept trying to get up and get out to go home. I can't imagine how hard that is.

1 person there really stood out to me though. One lady's husband was dead and she didn't remember that. Her son, apparently, was the spitting image of her husband when he was younger and she kept thinking that was her husband. Her son had no problem with this because it made her happy to have her life-long partner back with her. The ONE issue he did have is when mom tried to put the moves on him. Luckily he could laugh about it.

It's crushing when that happens. All I can try and do is meet them on their level. I can't bring them to me because their mental state won't let that happen. Instead, I try to relate to them. I ask them questions, I try to make them feel relaxed and valued. It's amazing how people settle when you make them feel like somebody really does give a shit. We all like to feel that way.

Many. I've had to deal with many residents who disliked me. I have to take into account they may not like because I'm a male and I'm significantly younger, so once I can eliminate that bias I can try and relate to them. I'm fortunate to have information about them in my care files so if I can at least relate for a few minutes, we can strike up conversation. It doesn't always work but it gets easier each time.